Limenda 7 vaginal suppositories — Made in Turkey — Free Delivery
(Limenda )
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Description Limenda 7 vaginal suppositories — Made in Turkey — Free Delivery
Indications
For local treatment of vaginal candidiasis, bacterial and Trichomonas vaginitis and vaginitis caused by mixed infections.
Application
1 suppository should be injected deep into the vagina at night for 7 days.
In case of recurrence of the disease or vaginitis resistant to other treatment, Limenda should be used within 14 days.
Vaginal suppositories must be inserted deep into the vagina using a disposable fingertip, which is in the package.
For elderly patients (over 65 years of age), dosage adjustment is not required.
Contraindications
Hypersensitivity to any of the active ingredients of the preparation or to their derivatives, porphyria, epilepsy, severe liver dysfunction.
Side effects
The frequency of systemic adverse reactions is negligible due to the very low level of metronidazole in blood plasma during vaginal administration of the preparation (2-12% compared with oral administration). miconazole nitrate can cause vaginal irritation (burning, itching), like all other antifungal agents containing imidazole derivatives used intravaginally (2-6%). these complaints quickly disappear with continued treatment. in case of severe irritation, treatment should be discontinued.
Adverse reactions registered with the systemic use of the active substances of the preparation are listed below.
On the part of the blood and lymphatic system: the frequency is unknown - leukopenia.
On the part of the blood and the immune system: the frequency is unknown - hypersensitivity reactions.
Mental disorders: infrequently - depression; rarely - mental disorders.
From the nervous system: rarely - ataxia, convulsions, dizziness, headache; the frequency is unknown - increased fatigue or weakness, peripheral neuropathy due to active and / or prolonged therapy with metronidazole.
From the digestive tract: the frequency is unknown - changes in taste, metallic taste, nausea, vomiting, constipation, dry mouth, diarrhea, lack of appetite, pain or cramps in the abdomen.
Violation of the general condition and condition at the injection site: very often - vaginal discharge; often - vaginitis, vulvovaginal irritation, discomfort of the pelvic organs; infrequently - a feeling of thirst; rarely - a feeling of heat in the vagina, itching, irritation, rash; frequency unknown - local irritation and hypersensitivity, contact dermatitis.
Side effects such as inflammation of the oral mucosa, stomatitis, glossitis, pancreatitis, hot flashes are also possible; rash, which may be accompanied by fever; urticaria, angioedema, anaphylactic shock, pustular rash; encephalopathy (e.g. confusion) and subacute cerebellar syndrome (e.g. ataxia, dysarthria, gait disturbance, nystagmus, tremor), which may resolve after discontinuation of the preparation, aseptic meningitis, psychotic disorders, confusion, hallucinations, diplopia, myopia, decreased visual acuity, changes in color perception, optic neuropathy/neuritis; agranulocytosis, neutropenia and thrombocytopenia, increased activity of liver enzymes (AsAT, AlAT, alkaline phosphatase), cholestatic or mixed hepatitis and hepatocellular liver damage, sometimes with jaundice; cases of liver failure requiring liver transplantation have been reported in patients treated with metronidazole and other antibiotics; increase in body temperature.
These side effects are rare, since the concentration of metronidazole in the blood is much lower with intravaginal administration.
special instructions
The patient should be warned that alcohol should not be consumed during therapy and within 2 days after completion of the course of treatment due to the possibility of reactions from the central nervous system, which are similar to the action of disulfiram.
High doses of the preparation and a long period of use can cause peripheral neuropathy and convulsions.
The suppository base may interact undesirably with rubber or latex, from which contraceptive diaphragms and condoms are made, so their simultaneous use with suppositories is not recommended.
Sexual partners of patients with trichomonas vaginitis should also be treated.
In renal insufficiency, the dose of metronidazole should be reduced.
In severe hepatic impairment, the clearance of metronidazole may be altered. Metronidazole may exacerbate the symptoms of encephalopathy due to its elevated plasma levels. Therefore, metronidazole should be used with caution in patients with hepatic encephalopathy. The daily dose for such patients should be reduced to 1/3.
For the elderly (over 65 years): the same recommendations as for other patients.
The preparation is not recommended for virgins.
Do not swallow suppositories or use the preparation in any way other than vaginal.
Use during pregnancy and lactation. Use in the first trimester of pregnancy is contraindicated. After the first trimester of pregnancy, Limenda can be used, weighing the risk/benefit ratio, as prescribed by a doctor and under his supervision.
During the use of the preparation, breast-feeding should be stopped, since metronidazole passes into breast milk. Breastfeeding can be resumed 1-2 days after the end of treatment.
Children. The preparation is not recommended for use in children.
The ability to influence the reaction rate when driving vehicles or working with other mechanisms. Compared with systemic administration, the absorption of metronidazole is significantly lower with vaginal administration. Dizziness, ataxia, psycho-emotional disorders may occur. In the presence of such symptoms, it is not recommended to drive vehicles or work with other mechanisms.
Interactions
Due to the absorption of metronidazole, preparation interaction reactions are possible with simultaneous use with certain substances and preparations:
Alcohol: The interaction of metronidazole with alcohol can cause a reaction similar to the interaction with disulfiram.
Oral anticoagulants: may increase the anticoagulant effec
Phenytoin: the concentration of phenytoin in the blood may increase, the concentration of metronidazole in the blood may decrease.
Phenobarbital: decrease in the concentration of metronidazole in the blood.
Disulfiram: CNS effects (psychotic reactions) are possible.
Cimetidine: The blood concentration of metronidazole may increase and the risk of neurotic symptoms may increase.
Lithium: possible increase in the toxic effects of lithium.
Astemizole and terfenadine: metronidazole and miconazole slow down the metabolism of these preparations and increase their plasma concentration.
There was also an effect on the concentration in the blood of liver enzymes, glucose (hexokinase method), theophylline and procainamide.
Acenocoumarol, anisindione, dicoumarol, phenindione, phenprocoumon, warfarin: increase the risk of bleeding.
Amiodarone: increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest).
Fluorouracil: increased blood levels of fluorouracil and increased toxicity.
Carbamazepine: an increase in the concentration of carbamazepine in the blood.
Cyclosporine: increased toxicity of cyclosporine.
Metronidazole can increase busulfan plasma levels, which can lead to significant toxic effects of busulfan. It is necessary to more often monitor the level of prothrombin and international normalized ratio with the simultaneous use of oral anticoagulants. Dose adjustment of the oral anticoagulant is recommended when using metronidazole and within 8 days after its withdrawal.
Due to the absorption of miconazole nitrate, preparation interaction reactions may occur when used simultaneously with certain substances and preparations.
Acenocoumarol, anisindione, dicoumarol, phenindione, phenprocoumon, warfarin: increased risk of bleeding.
Astemizole, cisapride and terfenadine: Miconazole slows down the metabolism of these preparations and increases their plasma concentrations.
Cyclosporine: increased risk of cyclosporine toxicity (renal dysfunction, cholestasis, paresthesia).
Fentanyl: increased or prolonged action of opioids (CNS depression, respiratory depression).
Phenytoin and fosphenytoin: increased risk of phenytoin toxicity (ataxia, hyperreflexia, nystagmus, tremor).
Carbamazepine: Decreased metabolism of carbamazepine.
Glimepiride: increased hypoglycemic effect.
Oxybutynin: an increase in the concentration of oxybutynin in the blood plasma and an increase in its effect (dry mouth, constipation, headache).
Oxycodone: an increase in the concentration of oxycodone in the blood plasma and a decrease in its clearance.
Pimozide: increased risk of cardiotoxicity (prolongation of the QT interval, torsades de pointes, cardiac arrest).
Tolterodine: increased bioavailability of tolterodine in individuals with a deficiency in cytochrome P450 2D6 activity.
Trimetrexate: increased toxicity of trimetrexate (bone marrow suppression, kidney and liver dysfunction, gastrointestinal ulcers).
Overdose
There are no data on intravaginal metronidazole overdose in humans. when introduced into the vagina, metronidazole can be absorbed in an amount sufficient to cause systemic effects.
If a large amount of the preparation accidentally enters the digestive system, if necessary, an appropriate method of gastric lavage should be used. Treatment is required in cases where 12 g of metronidazole has entered the digestive system. There is no specific antidote, symptomatic treatment is recommended. With an overdose of metronidazole, the following symptoms are observed: nausea, vomiting, abdominal pain, diarrhea, itching, metallic taste in the mouth, ataxia, vertigo, paresthesia, convulsions, leukopenia, dark urine.
With an overdose of miconazole nitrate, the following symptoms are observed: nausea, vomiting, inflammation of the throat and mouth, anorexia, headache, diarrhea.
Storage conditions
At a temperature not higher than 25 °C.
Tags: Limenda
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